by Hannah Farrell
How our expert witnesses can help
Our Expert Witnesses in Cardiothoracic Surgery are specialists at interpreting echocardiograms, angiograms, and myocardial perfusion scans, and are able to decipher what aortic surgery/heart surgery is necessary and appropriate. Further, their extensive experience in the operating theatre means they can review operation notes and assess the practical nature of the cardiothoracic procedures performed.
With a strong understanding of appropriate standards of care and NICE Guidelines, in addition to a thorough knowledge of treatment pathways, our Expert Witnesses in Cardiothoracic Surgery can advise on breach of duty and the potential repercussions of the same.
See below for a brief overview on Cardiothoracic Surgery. Alternatively, contact an Expert Witness in Cardiothoracic Surgery to see how they can help.
What is Cardiothoracic Surgery?
The heart and large blood vessels (aorta and vena cava) are major components of the thoracic cavity. They function to ensure oxygenated blood is circulated around the body to supply other organs and tissues. When things go wrong, individuals develop symptoms of breathlessness, chest pain, angina, dizziness, and syncope.
Acute Coronary Syndromes
The cardiac blood vessels supplying the myocardium (heart muscle) can become stenosed (hard and narrow), resulting in ischaemia (reduced blood supply) of the heart muscle. Patients will commonly present with central chest pain, and a diagnosis of angina is given. Should the cardiac blood vessels become occluded, the patient will suffer a myocardial infarction (MI), more commonly referred to as a ‘heart attack’. These can be categorised as an NSTEMI or STEMI, relating to the appearance on ECG. Cardiothoracic surgeons can perform coronary artery bypass grafting (CABG), whereby a blood vessel is taken from the patient’s leg or arm and used to bypass the blockage in the blood vessel, thus restoring blood flow to the heart muscle.
Valvular Cardiac Disease
The heart is comprised of four chambers (left and right atria, and left and right ventricles), where four major blood vessels either exit or enter. From the lungs, oxygenated blood passes into the left atrium, through the mitral valve and into the left ventricle. The mitral valve can become calcified and hard (mitral valve stenosis) or floppy (mitral valve regurgitation). From the left ventricle, oxygenated blood travels through the aortic valve, and into the aorta where it is then distributed around the body. The aortic valve can become calcified and hard (aortic stenosis) or floppy (aortic regurgitation). Heart valve disease often presents clinically with an audible heart murmur. In all cases of heart valve disease, the affected individual may require surgery such as, aortic valve replacement (AVR), mitral valve repair, or mitral valve replacement (MVR), to prevent further complications for example heart failure. Very rarely will individuals develop disease of the other two heart valves, the tricuspid valve and pulmonary valve.
Aortic Dissection/Aneurysm
The major artery, the aorta, exits the heart carrying oxygenated blood under extreme pressure. In certain individuals, the aortic root may enlarge (aortic aneurysm) and develop thin walls. Further, the aorta may split (aortic dissection) and may require emergency life-saving aortic surgery.